Health Sciences Institute, Department of Nutrition and Dietetics, Istanbul Okan University, Istanbul, Turkey.
Medical Faculty, Department of Public Health, Eskisehir Osmangazi University, Eskisehir, Turkey.
Support Care Cancer. 2021 Jun;29(6):3357-3365. doi: 10.1007/s00520-020-05856-5. Epub 2020 Oct 30.
The study aimed to determine the poor nutritional status, related factors, and its effect on the prognosis of patients with locally advanced and advanced stage lung cancer.
The study consisted of 539 patients, 412 (76.4%) of whom were non-small cell lung cancer (NSCLC), and 127 (23.6%) were small cell lung cancer (SCLC). The nutritional status of the patients was evaluated by the Controlling Nutritional Status (CONUT) and Prognostic Nutritional Index (PNI). Poor nutritional status was diagnosed with the CONUT score of ≥ 2 and PNI of ≥the median value. The factors related to nutritional status were determined using a multivariate logistic regression model. The effect of poor nutritional status on survival was calculated by Cox regression analysis.
The median age was 64 years (29-87). Poor nutritional status was found in 56.4% (57.8% for NSCLC and 52.0% for SCLC) and 49.2% (51.5% for NSCLC and 41.7% for SCLC) of patients according to CONUT and PNI, respectively. The factors associated with poor nutritional status according to CONUT were age, gender, KPS < 80, and BMI < 18.5 for NSCLC and KPS for SCLC. According to PNI, only KPS < 80 was associated with poor nutritional status by the multivariate logistic regression model. The median overall survival significantly decreased with poor nutritional status according to CONUT and PNI in NSCLC (p < 0.001 and p < 0.001, respectively) and in SCLC (p = 0.05 and p = 0.007, respectively).
Poor nutritional status is a common factor associated with poor prognosis in patients with locally advanced and advanced stage lung cancer. Patients should be screened for nutritional status and supported.
本研究旨在确定局部晚期和晚期肺癌患者的营养不良状况、相关因素及其对预后的影响。
本研究共纳入 539 例患者，其中 412 例（76.4%）为非小细胞肺癌（NSCLC），127 例（23.6%）为小细胞肺癌（SCLC）。采用 Controlling Nutritional Status（CONUT）和 Prognostic Nutritional Index（PNI）评估患者的营养状况。CONUT 评分≥2 分和 PNI 中位数以下诊断为营养不良。采用多变量 logistic 回归模型确定与营养状况相关的因素。采用 Cox 回归分析评估营养不良对生存的影响。
中位年龄为 64 岁（29-87 岁）。根据 CONUT 和 PNI，分别有 56.4%（NSCLC 为 57.8%，SCLC 为 52.0%）和 49.2%（NSCLC 为 51.5%，SCLC 为 41.7%）的患者存在营养不良。根据 CONUT，与 NSCLC 营养不良相关的因素为年龄、性别、KPS<80 和 BMI<18.5，而 SCLC 为 KPS。根据 PNI，仅 KPS<80 与多变量 logistic 回归模型中营养不良相关。根据 CONUT 和 PNI，NSCLC（p<0.001 和 p<0.001）和 SCLC（p=0.05 和 p=0.007）中，总体生存中位数随营养不良状况显著下降。
营养不良是局部晚期和晚期肺癌患者预后不良的常见因素。应筛查患者的营养状况并给予支持。
